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Nosebleed

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read
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Nosebleeds are also known by their medical name, epistaxis, and are extremely common. In most cases, nosebleeds are not concerning and tend to stop on their own within a couple of minutes or with the help of self-administered first aid. The majority of nosebleeds are caused by damage to the lining of the inside of the nose due to picking it or minor damage when you blow your nose.

Other causes of a nosebleed include suffering trauma to the nose or head, high blood pressure, poor blood clotting (this can be due to medication or medical conditions), or pregnancy, where changes in hormones lead to increased blood flow in the nose. Nosebleeds are also more common in young children and the elderly due to the lining of the nose being more fragile.

Healthwords pharmacists' top tips

Most nosebleeds do not need medical attention and can be treated successfully at home with self-administered treatment.

  1. The best thing to do during a nosebleed is sit down, lean slightly forwards and keep your chin tucked towards your head so that your head is tilted forwards.
  2. Pinch the soft lower part of your nose continuously for 10 minutes. Sitting forwards with your head tilted the same way helps the blood run out of your nose and not back towards your throat.
  3. Don’t pinch the hard upper part of the nose but you can put a wrapped ice pack or cold flannel on it to help stem the nosebleed.

When should I see my doctor?

You should book a routine visit with your doctor if you have regular nosebleeds. You should seek more urgent medical advice if the nosebleed occurs after a severe head injury, if the bleeding is profuse and lasts more than 20 minutes, if you are on blood-thinning medication, and if you have a known clotting disorder. This could be by calling your doctor, or going to the emergency department, depending on the severity.

The risks with severe nosebleeds are the loss of blood, but also the blood running back into the throat and blocking the airway. This is why forward positioning is important while you wait for medical help.

What will my doctor do?

The doctor will ask you about your medical history and your current symptoms. They will examine your nose and take basic health assessments such as your heart rate and blood pressure. They may also refer you to an ear, nose, and throat (ENT) specialist.

Emergency department doctors and ENT doctors are able to place different types of packs into the nose that help stop nosebleeds. These aim to help put pressure on the bleeding areas to stop the bleeding from continuing. Other treatment options include cauterization, which uses an electrical current or silver nitrate on the bleeding blood vessel in your nose to prevent it from continuing to bleed.

What are the do's or dont's after experiencing a nosebleed

Do's:

  1. Stay calm - Keep calm and reassure the person experiencing the nosebleed. Most nosebleeds are minor and can be easily treated at home.

  2. Sit up straight - Sit or stand upright and lean slightly forward. This helps prevent blood from flowing down the throat, which can cause nausea or vomiting.

  3. Pinch the nose - Using your thumb and index finger, pinch the soft part of the nose just below the bridge. Maintain pressure for 10-15 minutes or until the bleeding stops. Avoid releasing pressure too soon, as this can prolong bleeding.

  4. Apply cold compress - Apply a cold compress or ice pack wrapped in a cloth to the bridge of the nose. This helps constrict blood vessels and reduce swelling, which can help stop the bleeding.

  5. Stay hydrated - Drink plenty of fluids to stay hydrated. However, avoid hot drinks immediately after a nosebleed, as heat can dilate blood vessels and increase the risk of bleeding.

  6. Use nasal saline spray - After the bleeding has stopped, use a saline nasal spray to keep the nasal passages moist and prevent dryness, which can contribute to nosebleeds.

  7. Monitor for recurrence - Keep an eye on the person for any signs of recurrent bleeding, such as persistent dripping or oozing from the nose. Seek medical attention if bleeding persists or if the person experiences frequent nosebleeds.

Don'ts:

  1. Tilt the head back - Avoid tilting the head back, as this can cause blood to flow down the throat and into the stomach, leading to nausea, vomiting, or aspiration.

  2. Blow the nose - Avoid blowing the nose forcefully immediately after a nosebleed, as this can dislodge blood clots and trigger further bleeding.

  3. Insert objects into the nose - Do not insert tissues, cotton swabs, or other objects into the nose to try to stop the bleeding, as this can cause further irritation or injury to the delicate nasal tissues.

  4. Engage in strenuous activities - Avoid strenuous physical activities, heavy lifting, or vigorous exercise immediately after a nosebleed, as this can increase blood pressure and the risk of recurrent bleeding.

  5. Consume hot foods or beverages - Refrain from consuming hot foods or beverages immediately after a nosebleed, as heat can dilate blood vessels and increase the risk of bleeding.

  6. Pick or rub the nose - Avoid picking or rubbing the nose, as this can irritate the nasal passages and increase the risk of recurrent bleeding.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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